[Acute multifocal placoid pigment epiteliopathy]

Acute multifocal placoid pigment epitheliopathy is a fairly rare disease with unknown etiology and pathogenesis, possibly a focal response to a systemic inflammatory process. We present the case of a young patient who developed bilateral placoid retinal lesions, in different stages of evolution - cicatriceal lesions of the right eye and mixed cicatriceal and active lesions of the left eye. Investigations showed old immunity to cytomegalovirus and toxoplasma. Fluorescein angiography showed the typical fluorescein pattern (hypoflurecence in early phases and hyperfluorescence in late phases). The case is unique because of the atypical findings: choroidal neovascularization in the left eye (rarely occurs in acute multifocal placoid pigment epitheliopathy but more commonly in serpiginous choroidopathy), recurrences, asymmetry between the two eyes (at the time of investigations visual acuity is markedly depressed in the right eye - 1/10 and the left macula is threatened by the choroidal neovascularization).